Franka E, El-Zoka A H, Hussein A H, Elbakosh M M, Arafa A K, Ghenghesh K S
Faculty of Medicine, Al-Fateh University for Medical Sciences, Tripoli, Libya.
J Hosp Infect. 2009 Jul;72(3):258-61. doi: 10.1016/j.jhin.2009.03.019. Epub 2009 May 13.
Medical waste handlers (MWHs) are at risk of exposure to serious viral infections. No data are available on the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) among MWHs in Libya. During a one-year period (January to December 2004) blood samples from 300 (59 females) MWHs employed by a local contractor in Tripoli and 300 blood samples from non-medical waste handlers (NMWHs) who had no direct or indirect contact with medical waste were examined for HBV, HCV and HIV using enzyme-linked immunosorbent assays. HBV was detected in 7 (2.3%) and 1 (0.3%) and HCV in 8 (2.7%) and 0 (0.0%) of MWHs and NMWHs, respectively. Significant differences were observed in the detection rates of HBV (OR: 7.14; P<0.04) and HCV (OR: undefined; P<0.005) in MWHs when compared with NMWHs. HIV was not detected in both groups. Of the MWHs studied, 21% were immunised against HBV and 7% were trained to handle medical waste. In addition, 99.7% wore overalls, 57.7% thick disposable gloves, 55% boots and 17.7% masks while handling medical waste. In conclusion, prevalence rates of HBV and HCV were significantly higher in MWHs than those in NMWHs examined. Training, immunisation, and post-exposure protection of MWHs, in addition to proper management of medical waste by the health authorities, may significantly reduce the risk of acquiring infectious agents by MWHs in Libya.
医疗废物处理人员(MWHs)面临感染严重病毒的风险。目前尚无关于利比亚医疗废物处理人员中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)或人类免疫缺陷病毒(HIV)流行率的数据。在一年期间(2004年1月至12月),对的黎波里一家当地承包商雇佣的300名医疗废物处理人员(59名女性)的血样以及300名与医疗废物无直接或间接接触的非医疗废物处理人员(NMWHs)的血样进行了检测,采用酶联免疫吸附测定法检测HBV、HCV和HIV。医疗废物处理人员和非医疗废物处理人员中,分别有7名(2.3%)和1名(0.3%)检测出HBV,8名(2.7%)和0名(0.0%)检测出HCV。与非医疗废物处理人员相比,医疗废物处理人员中HBV(比值比:7.14;P<0.04)和HCV(比值比:未定义;P<0.005)的检测率存在显著差异。两组均未检测出HIV。在所研究的医疗废物处理人员中,21%接种了乙肝疫苗,7%接受了医疗废物处理培训。此外,99.7%的人在处理医疗废物时穿工作服,57.7%的人戴厚一次性手套,55%的人穿靴子,17.7%的人戴口罩。总之,医疗废物处理人员中HBV和HCV的流行率显著高于所检测的非医疗废物处理人员。除了卫生当局对医疗废物进行妥善管理外,对医疗废物处理人员进行培训、免疫接种和接触后保护,可能会显著降低利比亚医疗废物处理人员感染病原体的风险。